Senses are the way we detect our world, helping us understand what we see, hear, touch, smell and taste. We also have three other senses which help us to detect the world. They are largely unknown but play a crucial role in how we feel. These senses are called vestibular, proprioception and interoception. Vestibular helps us with balance and posture. Proprioception is the feedback we get from joints and muscles. And interoception is the internal interpretation of our emotions and bodily functions, such as being hungry or needing the toilet.

Over the coming months, we will share a series of articles which will look in more depth at some of the key senses which underpin development, how these might be negatively impacted through trauma and neglect and strategies to help manage these.

This month we will consider the tactile sense of touch. Touch is fundamental to how we feel and is thought to be the most important sense in determining our behaviour. Touch develops in the womb with an unborn baby experiencing deep pressure when surrounded by amniotic fluid. Our experience of touch helps us feel calm and impacts on our attachment to those who are important in our lives. Often when children have experienced trauma and neglect their touch system is on hyper alert, which means that touch can be perceived as being uncomfortable or even painful.

We have a number of receptors which detect pressure, vibration, texture, heat, pain and crude touch. When touch is difficult, children can find certain textures, such as a seam or label in their clothes, hard to tolerate. Everyday activities such as having a shower can even be perceived as painful. Children and young people may find crowded and busy places difficult to cope with due to their anxiety about touch.

The way to help a child  if they perceive touch as uncomfortable, is to think developmentally. Many children miss out on close nurturing when first born and during their early weeks, months and years. If children and young people have access to soft fleecy blankets or toys, sleeping bags and warmth it can be very comforting, especially during busy or stressful times. Deep pressure from hugs or weighted equipment can also help. Make sure you always follow the guidelines when using weighted equipment as it can significantly reduce or even prevent movement. Some children enjoy having fleecy bedding and nightwear or using soft fluffy towels after a bath or shower. Do be aware of the temperature of the bathroom as cold environments can heighten discomfort. Finally, firm touch is less stressful than light, but do be aware that unexpected or spontaneous touch may be challenging. You can prepare the child for touch by letting them know what you intend to do in advance. You can  also give a child consent to initiate physical contact as this may help them develop a greater tolerance of touch.

Moira Veira (MSc Sensory Integration) – Advanced Occupational Therapist

We would like to thank senSI, specialist Sensory Integration Experts, for this article.